Serrated Epithelial Change Is Associated With High Rates of Neoplasia in Ulcerative Colitis Patients: A Case-controlled Study and Systematic Review With Meta-analysis.

Case-Control Studies Colitis, Ulcerative / complications Colorectal Neoplasms / epidemiology Humans Intestinal Mucosa / pathology Logistic Models
colorectal cancer dysplasia neoplasia serrated epithelial change ulcerative colitis

Journal

Inflammatory bowel diseases
ISSN: 1536-4844
Titre abrégé: Inflamm Bowel Dis
Pays: England
ID NLM: 9508162

Informations de publication

Date de publication:
19 08 2021
Historique:
received: 31 08 2020
pubmed: 10 12 2020
medline: 10 2 2022
entrez: 9 12 2020
Statut: ppublish

Résumé

Patients with long-standing ulcerative colitis (UC) are at an increased risk of colorectal cancer. Risk stratification is important to identify patients who require more frequent endoscopic surveillance. Serrated epithelial change (SEC) found in patients with long-standing colitis may be associated with neoplasia and serve as a marker to stratify patients at higher risk of colorectal cancer (CRC). A case-control study was performed to compare the rates of neoplasia between UC patients with SEC and UC patients without SEC who were matched for age, disease duration, and disease extent. Paired tests, conditional logistic regression, and Kaplan-Meier analyses were used to compare groups. A systematic review with meta-analysis was performed, combining our local data with previously published data. This study included 196 UC patients without prior neoplasia, 98 with SEC and 98 without SEC. Ulcerative colitis patients with SEC had a significantly higher rate of synchronous or metachronous neoplasia than UC patients without SEC (26.5% vs 3.1%; P < 0.001). Synchronous or metachronous high-grade dysplasia and CRC were found more frequently in UC patients with SEC than UC patients without SEC (11.2% vs 2.0%; P = 0.02). A meta-analysis was consistent with these findings, showing a higher rate of neoplasia in patients with SEC compared with those without SEC (16.4% vs 3.9%; P < 0.001). Serrated epithelial change is associated with a significantly increased risk of synchronous and metachronous neoplasia including high-grade dysplasia and CRC in patients with UC. Histopathological findings of SEC should warrant closer endoscopic surveillance for CRC.

Sections du résumé

BACKGROUND
Patients with long-standing ulcerative colitis (UC) are at an increased risk of colorectal cancer. Risk stratification is important to identify patients who require more frequent endoscopic surveillance. Serrated epithelial change (SEC) found in patients with long-standing colitis may be associated with neoplasia and serve as a marker to stratify patients at higher risk of colorectal cancer (CRC).
METHODS
A case-control study was performed to compare the rates of neoplasia between UC patients with SEC and UC patients without SEC who were matched for age, disease duration, and disease extent. Paired tests, conditional logistic regression, and Kaplan-Meier analyses were used to compare groups. A systematic review with meta-analysis was performed, combining our local data with previously published data.
RESULTS
This study included 196 UC patients without prior neoplasia, 98 with SEC and 98 without SEC. Ulcerative colitis patients with SEC had a significantly higher rate of synchronous or metachronous neoplasia than UC patients without SEC (26.5% vs 3.1%; P < 0.001). Synchronous or metachronous high-grade dysplasia and CRC were found more frequently in UC patients with SEC than UC patients without SEC (11.2% vs 2.0%; P = 0.02). A meta-analysis was consistent with these findings, showing a higher rate of neoplasia in patients with SEC compared with those without SEC (16.4% vs 3.9%; P < 0.001).
CONCLUSION
Serrated epithelial change is associated with a significantly increased risk of synchronous and metachronous neoplasia including high-grade dysplasia and CRC in patients with UC. Histopathological findings of SEC should warrant closer endoscopic surveillance for CRC.

Identifiants

DOI: 10.1093/ibd/izaa312 PMID: 33295614
pubmed: 33295614
pii: 6028664
doi: 10.1093/ibd/izaa312
doi:

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1475-1481

Informations de copyright

© 2020 Crohn’s & Colitis Foundation. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Auteurs

Alyssa M Parian (AM)

Department of Gastroenterology & Hepatology, Johns Hopkins University, Baltimore, MD, USA.
ORCID: 0000-0001-9995-7942

Berkeley N Limketkai (BN)

Department of Gastroenterology & Hepatology, Johns Hopkins University, Baltimore, MD, USA.
Vatche & Tamar Manoukian Division of Digestive Diseases, UCLA School of Medicine, Los Angeles, CA, USA.

Reezwana Chowdhury (R)

Department of Gastroenterology & Hepatology, Johns Hopkins University, Baltimore, MD, USA.

Gala Godoy Brewer (GG)

Department of Gastroenterology & Hepatology, Johns Hopkins University, Baltimore, MD, USA.

George Salem (G)

Department of Gastroenterology & Hepatology, Johns Hopkins University, Baltimore, MD, USA.

Katie Falloon (K)

Department of Gastroenterology, Cleveland Clinic, Cleveland, OH, USA.

Florin Selaru (F)

Department of Gastroenterology & Hepatology, Johns Hopkins University, Baltimore, MD, USA.

Joanna Melia (J)

Department of Gastroenterology & Hepatology, Johns Hopkins University, Baltimore, MD, USA.

Mark G Lazarev (MG)

Department of Gastroenterology & Hepatology, Johns Hopkins University, Baltimore, MD, USA.

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Classifications MeSH

questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études cas-témoins › Serrated Epithelial Change Is Associated With...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies gastro-intestinales › Maladies intestinales › Maladies inflammatoires intestinales › Rectocolite hémorragique › Serrated Epithelial Change Is Associated With...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies gastro-intestinales › Maladies intestinales › Maladies du rectum › Tumeurs colorectales › Serrated Epithelial Change Is Associated With...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Serrated Epithelial Change Is Associated With...
questionsmedicales.fr › Tissus › Membranes › Muqueuse › Muqueuse intestinale › Serrated Epithelial Change Is Associated With...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Analyse de régression › Modèles logistiques › Serrated Epithelial Change Is Associated With...